氧化三甲胺及其与动脉粥样硬化关系的研究进展

正心脑血管疾病是目前人类死亡最主要的原因之一,而动脉粥样硬化(atherosclerosis, AS)是其主要的病理基础。氧化三甲胺(trimethylamine oxide, TMAO)是肠道菌群的代谢产物,有研究发现高水平TMAO与AS的发生发展显著相关[1-2],但其导致AS的机制仍然未明。本研究将从TMAO的一般特性、TMAO促进AS的可能机制以及如何干预TMAO来防治AS这几方面进行阐述。1 TMAO的一般特性     

CYP2C19 Polymorphism and Clinical Outcomes among Patients of Different Races Treated with Clopidogrel:A Systematic Review and Meta-Analysis

Several studies have investigated the association between CYP2C19 polymorphism and clinical outcomes of patients treated with clopidogrel, but few have noticed the difference in association between Westerners and Asians. We searched MEDLINE, EMBASE and Cochrane Library database and conducted a systematic review and meta-analysis. Thirty-six studies involving 44 655 patients with coronary artery disease(CAD) treated with clopidogrel were included, of which more than 68% had undergone percutaneous coronary intervention(PCI). The primary outcome of our interest was the recurrence of major adverse cardiovascular events(MACE) in those CAD patients. Firstly, we found that the distribution of reduced-function CYP2C19 allele varied between Westerners and Asians. Among Asians, 1 and 2 reduced-function CYP2C19 mutant allele carriers accounted for 42.5% and 10%, respectively. While among Westerners, 1 and 2 reduced-function CYP2C19 mutant allele carriers accounted for 25.5% and 2.4%, respectively. Secondly, the impact of CYP2C19 polymorphism on clinical outcomes of patients treated with clopidogrel varied with races. Among Asians, only 2 reduced-function CYP2C19 mutant allele carriers had the reduced effect of clopidogrel. And the reduced effect was significant only after the 30 th day of treatment. While among Westerners, both 1 and 2 reduced-function CYP2C19 allele carriers had the reduced effect, and it mainly occurred within the first 30 days. Thirdly, the safety of clopidogrel was almost the same among races. Reduced-function allele non-carriers had higher risk for total bleeding but did not have higher risk for major bleeding. It is suggested that CYP2C19 polymorphism affects the efficacy of clopidogrel differently among Westerners and Asians.     

千金苇茎汤加减治疗中央型肺癌1例报告

<正>肺癌是严重危害人类健康的疾病,其发病率及死亡率均居全球癌症之首[1]。肺癌在中医中称为"肺积"。已有文献报道,中医传统方法对肺癌具有一定的效果[2]。本文通过随访1位男性中央型肺癌患者5年,主要探讨千金苇茎汤抗肿瘤的疗效。1临床资料患者谢某,男,49岁,工人。2010年1月15日因"咳嗽、胸痛1月余"入院。个人史:有吸烟史20余年,平均10支/d。入院时体检:T 36.5℃,P 89bpm,R 20次/min,BP 125/80mm Hg,     

中医药治疗非酒精性脂肪性肝病研究进展

非酒精性脂肪性肝病(Nonalcoholic fatty liver disease,NAFLD)是指除酒精和其他明确的肝损害因素所致的,以弥漫性肝细胞大泡性脂肪病变为主要特征的临床综合征,包括单纯性脂肪性肝病及由其演变的脂肪性肝炎和肝硬化。该病病理机制复杂,西医学中尚无有效药物及治疗手段。中医学博大精深,对NAFLD的治疗卓有成效且手段多样,现将近年来对NAFLD的中医病因病机及常用中医治疗方法的研究进展概况做一综述。     

基于格兰杰因果分析的针刺不同效应阶段中枢神经传导通路研究

目的探讨针刺不同效应阶段是否会引发中枢神经信号不同的传导通路。材料与方法采用非重复事件相关的实验设计模式和多元格兰杰因果有效连接度分析方法。结果研究表明针刺即时效应仅引发大脑微弱、稀疏的因果有效连接,包括经丘脑的体感上行传导通路与由额叶皮层投射到疼痛反应区的自上而下的控制通路。持续性效应阶段,仅在针刺足三里穴后会引发广泛大脑区域的更为紧密的因果连接模式。结论针刺效应可能涉及大脑网络多水平层面信息流的整合与交互。     

急性前循环供血区脑梗死患者血清NSE及S100B水平变化及其对预后的评估价值

目的 探讨血清神经元特异性烯醇化酶(Neuron specific enolase, NSE)及S100B水平对急性前循环供血区脑梗死(Cerebral infarction with acute anterior circulation, CIAAC)患者病情严重程度及预后预测的评估价值。方法 选取2021年5月-2022年5月武汉大学人民医院神经内科收治的CIAAC患者121例，入院时根据美国国立卫生院卒中量表(National institutes of health stroke scale, NIHSS)评分将患者分为轻度组(n=25)、中度组(n=31)、重度组(n=39)、极重组(n=26);根据半年后的改良Rankin量表评分分为预后良好组(n=68,mRS≤2分)和预后不良组(n=53,mRS>2分)2个亚组。结果 轻度组、中度组、重度组、极重组血清NSE及S100B水平均依次升高(P<0.05)。Spearman相关性分析显示，CIAAC患者NSE,S100B水平与NIHSS评分呈正相关(r=0.846,P<0.001;R=0.939,P<0...